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(2008) In early May, four months after fifteen-year-old Jordan became Alice I get a panicked phone call from her therapist twenty minutes before I'm scheduled to pick her up. I leave work and drive over immediately, arriving ten minutes later to find the therapist Linda slumped on the couch in her waiting room, with the inner and outer doors to her office wide open. She sits up abruptly when I enter.

“She stormed out of here twenty minutes ago” Linda blurts out, “She punched the emergency callbox in the hallway and disappeared. She was in a mood when she got here. Like really agitated. I got her settled down enough to talk and asked a couple of questions, then she just lost it.” Linda runs her hands through her spiky hair and exhales heavily.

“The estrogen can bring emotions closer to the surface, that's one of it's side effects.” I tell her. “What were you talking about when she ran out of here?”

“I'd asked her what was bothering her, if it was school or home, or if it was this girl thing, if she just wanted things to go back to the way they were. I wanted her to know that it was ok, if she did.”

Immediately, I know that last piece was enough to set her off all on its own. I also know that I need to go and find her, but I'm having a hard time disengaging from Linda, who looks absolutely crushed.

“She just screamed 'You don't get it AT ALL' and she started crying. In the eight months we've been working together, I've never seen her cry. I'm so sorry.”

“It's ok” I say, when it's so obvious that nothing is ok.

I leave Linda's office and rush down the stairs outside the building to find Alice pacing in circles around my car. I recognize her expression as the one she wears when she cuts herself or slams her body into walls. It's the one she was wearingthat day she sat in the windowsill last year and threatened to let herself fall. We get in and drive away in silence. I'm honestly afraid to speak and she is radiating sparks like a frayed wire. Two blocks from home, I make a right-hand turn instead of going straight and wind my way through the hospital parking lot, finding a spot right in front of the Emergency Room. I turn off the engine and just sit quiet for a moment.

“I think we should go in.” I say, leaving room for an argument or discussion.

“Me too.” she says quietly.

And just like that, fifteen months after our first psych visit to the ER, we walk through those doors and submit ourselves to the process. Within an hour of our arrival, the doctor has seen her, a psych consult has been ordered and a nurse in lemon yellow scrubs comes to give her a sedative. Alice has been pacing around the cramped exam room for most of the visit but she hops right up on the bed like a well-behaved patient when the nurse comes in with a med tray.

“We're going to give you a low dose of Ativan just to calm you down a bit.” The nurse says, spilling the pill into Alice's palm and handing her a paper cup of water.

“What's the dose?” Alice asks.

“One milligram, it's really just to help you relax.”

Alice pops he pill and empties the cup.

It's another couple of hours before the on-call Social Worker arrives. I'm half-hoping we'll get the same blocky woman as before with her calming presence and super-efficiency. Instead, a slight man with thick glasses comes into the room with the lemony nurse and introduces himself as Jim.

He pulls a stool up beside Alice's bed and fusses with a notebook for a moment. The Ativan has done it's job and Alice is calm, curled on her side under a warm blanket.

“How are you feeling?” Jim asks.

“Sad … tired”

“Angry?” he prods.

“I was. I'm not now.”

I take this moment to step out and run down the hall to the restroom. While I'm in there, I call home to fill Max in and ask him to find something in the freezer to cook for himself and Jay for dinner. When I return to the exam room, Jim motions for me to join him out in the hall.  We sit a few feet from Alice's room and he glances down at his notes.

“Who is this Dr. Deborah?” He asks first, catching me off guard.

“She's one of Alice's doctors, from the health clinic in San Francisco.”

“And she's an actual licensed physician?”

“Of course.”

“Frankly I'm surprised. I can't imagine any ethical doctor putting a child through something like this.”

“We're not putting her through anything sir.”

“Jim”

'I don't know what you know about Gender Identity Disorder, Jim, but ...”

“This is very adult stuff, Mrs. Vilmur. Most people don't decide to become transsexual uuntil in their thirties or forties.”

There is so much wrong with what he just said that I laugh out loud, which I'm sure does nothing to improve his opinion of me since he immediately begins scribbling in his notebook again.

“Look Jim, your ignorance of trans teenagers isn't really important. There's something else going on. I don't know if it's drugs or depression or both. I just need to know if you're going to admit her or not.”

“I'm going to recommend we admit him to one of the nearby psychiatric facilities and get him some GOOD mental health care. Hopefully they can help sort things out.”

“Great” I stand up and walk back into her room without another word.

“Jim's an ass” Alice whispers when I sit down beside her. “He asked more questions about Dr. Deborah than he did about me.” Then she closes her eyes and pulls the blanket up to her chest, one arm lolling out, upturned with a row of tiny razor cuts from elbow to wrist.

 I sit and watch her sleep for the next three hours and then the ambulance arrives to transport her to Sacramento. She wakes long enough to be strapped onto a gurney and hug me before they roll her out the door.  

I don't care if Mr. Jim of Social Services thinks I'm a terrible parent or if Linda still thinks that this gender transition is just a phase. All I really care about right now is taking away whatever pains Alice.

[Note: The final year of my daughter's life was a revelation and I wouldn't trade it for anything. I tell her story in bits and pieces as part of my own therapy, but also to let others who may travel some piece of the same path; You are not alone. This piece and previous diaries about Alice are cross-posted at Laurustina.com.]

Originally posted to laurustina on Sun Jan 13, 2013 at 03:26 PM PST.

Also republished by KosAbility and Mental Health Awareness.

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